[Contrast-enhanced MR "magnetization transfer technique". Improved tumor contrast, delineation and visibility of intracranial malignant gliomas and metastases in radiosurgical treatment planning].
OBJECTIVE
To improve tumor conspicuity and delineation on contrast-enhanced T1-weighted MR images with and without magnetization transfer (MT) contrast as a strategy to improve the macroscopic boost volume definition in the planning process of radiosurgery in patients with high grade gliomas or metastatic brain lesions.


METHODS
Thirty-two patients (mean age 47 years) with histologically proven or suspected high grade glioma (n = 12) or metastatic brain lesions (n = 20) were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight) the lesions were imaged with a T1-weighted MT-fast low angle shot (FLASH) pulse sequence and with a conventional T1-weighted SE sequence without MT saturation.


RESULTS
The mean CNR of enhancing lesions on T1-weighted MT-FLASH was 15 +/- 5 compared to 11 +/- 4 on SE images, representing a significant (p < .01) improvement. The mean tumor diameter of malignant gliomas was significantly (p < .01) larger measured on T1-weighted MT-FLASH images compared to those obtained from T1-weighted SE images and were comparable for metastatic lesions. Lesion conspicuity and delineation were improved in 50% of patients with high grade gliomas and in 35% of patients with brain metastases. Lesion conspicuity was markedly improved in the posterior fossa. Additional contrast enhancing lesions were detected in 10% of patients with metastases on MT-FLASH images.


CONCLUSIONS
It is concluded that contrast-enhanced MT-FLASH images may improve lesion detection and delineation in the planning process of radiosurgery in patients with intracranial high grade gliomas or metastases or even alter the treatment approach.
Hawighorst
H
H
Abteilung Radiologische Diagnostik und Therapie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg.
Schreiber
W
W
Debus
J
J
Knopp
M V
MV
Engenhart-Cabillic
R
R
Brix
G
G
Essig
M
M
van Kaick
G
G
D000328:Adult; D001254:Astrocytoma / Q000175:diagnosis / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005909:Glioblastoma / Q000175:diagnosis / Q000601:surgery; D005910:Glioma / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D016634:Radiosurgery
D003287:Contrast Media; D019786:Gadolinium DTPA
Kontrastmittelunterstützte MR "Magnetization-transfer-Technik". Verbesserter Tumorkontrast, Abgrenzbarkeit und Sichtbarkeit von intrakraniellen malignen Gliomen und Metastasen zur Tumorerkennung für die Radiochirurgie.